Halimeter for Bad Breath Diagnosis

Many specialists in oral malodor now use the halimeter®, by Interscan Corporation to assess patients who consult them about a breath problem. Simple but ingenious, the device draws in a sample of mouth air through a straw, analyzes it for certain gases and provides a readout of the gases quantified in parts per billion (ppb). This scientific breath analysis is based on the knowledge that the foul odors associated with halitosis are usually volatile sulfur compounds (VSC) produced by anaerobic bacteria (microorganisms that live in places where there is little or no oxygen) breaking down proteins in the mouth. Although almost everyone has some VSC in his or her mouth, the gases are only noticeable to others at levels of about 200 ppb and higher. A quantitative measurement of VSC is, therefore, very helpful in diagnosing and monitoring halitosis.

Until recently, the organoleptic assessment of halitosis was the standard method of diagnosing and grading breath malodor. In this procedure, an examiner asks the patient to blow air through a straw and assesses the severity of the odor based on a point scale. Though every effort is made to obtain objective results, the grade is unavoidably based on an individual’s subjective impressions. Results of this type of testing are described as having low specificity and reproducibility (Lee, PPC and WY Mak. “The Aetiology and Treatment of Oral Halitosis: An Update. Hong Kong Medical Journal Vol.10 No. 6, 2004: 414-418), meaning that the procedure doesn’t test for specific odor sources, and that if the test is repeated on the same patient, different results are often obtained. The advent of the halimeter® for bad breath diagnosis is a clear advance in this difficult medical challenge.

There are few disadvantages to the halimeter® for bad breath diagnosis. One is that the cost of the instrument and the expertise required to operate it mean that the patient must consult a medical professional in order to have the test done (also true for the organoleptic assessment of halitosis). Though this may involve some cost, it does provide a professional assessment of the patient’s condition and increases the probability that a serious underlying medical problem will be caught early, as well as insuring accurate test results. In addition, the halimeter® does not measure all of the foul smelling gases associated with oral malodor, only the three common ones, so a rare case where other gases are involved may go undetected.

In order to get accurate results from the Halimeter for Bad Breath Diagnosis, patients must abstain from eating, drinking, smoking, chewing gum, using oral hygiene products, or sucking candies for a specified period of time before the procedure. It is important to follow the instructions of the person performing the test. The procedure is quick, painless, and carries virtually no risk. As a more accurate alternative to the organoleptic assessment of halitosis, it is likely to become the standard method of measuring oral malodor.

Tests to Monitor Bad Breath

Because halitosis has only recently become a serious area of scientific and medical research, tests to monitor bad breath have also been slow in coming. Traditionally, the only way to check whether you had halitosis was to ask someone, preferably a doctor or dentist, to smell your breath and offer an opinion. This method is subjective and affected by the temporary effects of such things as food odors, tobacco, and even breath mints, and responses vary depending on the sensitivities of the informant. An objective, professional approach to assessing breath odor has been wanting for a long time, but a few methods are now available.

The most technical of the tests to monitor bad breath to date is the halimeter® by Interscan Corporation, a device that analyzes breath samples for volatile sulfur compounds (the gaseous breakdown products of oral bacteria known to be associated with breath odor). Using the halimeter® for halitosis measurement involves placing a straw in the mouth and waiting while the machine takes in a fifteen second air sample, which it then analyzes for the gases hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. It then provides a measurement of the gases present in parts per billion (ppb). Because everyone probably has some of these bacteria and therefore minimal levels of these gases, results are interpreted according to how many ppb typically result in a detectable odor in the air.

The halimeter® for halitosis measurement can analyze mouth air, nose air and even lung air, depending on the sampling procedure used. This is helpful because, although most breath odor originates in the mouth, there are situations where a problem exists in the lungs or nasal sinuses, and in these cases, air samples from different locations help narrow down the problem. Clearly, compared to tests to monitor bad breath that can’t differentiate between possible origins of the odor, the instrument provides superior results.

Using the halimeter® for halitosis measurement is not foolproof. The procedure must be performed correctly and certain things can interfere with test results (carefully follow all instructions to abstain from smoking, eating, drinking, brushing, chewing gum etc. before the test.). In some cases the gases involved with breath malodor are not the three volatile sulfur compounds that the instrument measures. Nonetheless, for most people, this is the test of choice. Other tests to monitor bad breath include gas chromatography, a difficult and specialized test impractical for routine use; and organoleptic measurement, where the human nose remains the testing instrument but an effort is made to remove the inherent subjectivity.